Jay Galbraith Gould Jr., PH D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

006296 Issued in NY

Practice address

11021 73Rd Road
1J
Forest Hills, NY 11375

Phone

(516) 759-1979

Fax

(516) 759-1979

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1699795013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SALEM WAY",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451136",
            "telephone_number": "516-759-1979",
            "fax_number": "516-759-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11021 73RD ROAD",
            "address_2": "1J",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "516-759-1979",
            "fax_number": "516-759-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "JAY",
        "middle_name": "GALBRAITH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PH D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "006296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Goodwin, MHC
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• Karoline Gostl, LAC.
• Vladimir Gotlieb, MD
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• Psychologist in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.